ST LUKE'S Hospice in Plymouth provides specialist end of life care to thousands of patients a year across West Devon. Most believe that St Luke's Hospice Inpatient Unit in Turnchapel is its only focus for providing care — but this is a common misconception. In fact, only 11% of their care is conducted in the hospice, with 39% caring for people at home and 29% in Derriford Hospital. And now, the organisation is about to launch a new, crisis team to work within the community. More than £4.5-million a year fundraising is required to run St Luke's so that it can provide care, free of charge, to the local community. The aim of St Luke's is to provide the highest quality end of life and to alleviate pain and distressing symptoms, offering practical, emotional and spiritual support to patients, their families and their carers. Research has shown that most people's wish is to die at home, and with that in mind St Luke's Hospice has developed its vision of a 'Hospice without Walls', where quality end of life care for patients at home, in care homes, community hospitals and acute hospitals, has been provided by a dedicated community team. Derek Hart, a community specialist palliative care nurse, is one member of the community team, committed to educating end of life care in nursing and residential homes, and supporting staff in the West Devon area. He said: 'We want to keep patients at home if it is their wish, as opposed to going to St Luke's Hospice or Derriford — as for people in the Tavistock area, Turnchapel is a long trek. 'We work really hard to bring care to where they are.' In one typical day for Derek he can travel up to 60 miles and see up to four people and their families with end of life care decision-making, helping with pain management, helping district nurses, and working with GPs and nurses. 'I have around 25 to 35 people on my case load, and I work with district nurses and GPs, we have a very good relationship. GPs and nurses are very much part of the team — it's an important partnership.'  Maggie Draper, head of community services, said: 'What Derek and the team do is amazing and is a very important part of St Luke's as care needs to be taken out to people in their own home.' The services currently delivered by the community team will be developed to run alongside a brand new care team, which is being launched in October this year. St Luke's Crisis Nursing Team is a type of 'Hospice at Home' — a short-term crisis intervention team for a 72 hour window. Maggie said: 'We aim to deliver care in a different way and move with the times. 'This is a big step up for the hospice and it's a bold thing to do. 'The Inpatient Unit will always be there for patients that have more complex conditions and cannot be cared for at home, but we believe this change will help us reach more people at home and in rural areas like Tavistock were there is a need for this care. 'Research shows that we need more help at the end to stop people going in to hospital, when it is their wish to die at home. 'With the crisis team, for example, if someone is very poorly and their wish is to die at home, then the team will work fast to get everything sorted to make it possible. 'I know there are risks for being at home, but I would rather they get the care they want and stay at home if it is their wish, in their own surroundings, than be in hospital. 'There are things we can do and we will do to pull out all the stops for their care.' St Luke's will be investing £600,000 from its reserves to help start the crisis team. It will be reducing its in-patient beds from 20 to 12 over the next year as part of its vision of creating a 'Hospice without Walls' by re-investing savings into its community nursing services to allow St Luke's to meet the growing demand of dying patients to be cared for within their own home. Robert Maltby, communications and marketing manager, said: 'People don't realise that St Luke's covers a wide area around Tavistock. 'We want people to realise that it's not just Plymouth and not just the in-patient unit at Turnchapel — Tavistock is a big area for St Luke's and there is a large number of people we care for — 85 in the Tavistock area in the last year alone.' A recruitment open morning is being held on Monday (July 21) for any registered nurses or care assistants who wish to be part of the new 24-hour crisis team. • To find out more visit the open day at St Luke's Pearn premises, Eggbuckland Road, Plymouth, from between 10am and 1pm. Job descriptions can be viewed from July 21 at http://www.stlukeshospice.org.uk">www.stlukeshospice.org.uk